Abstract
Geographic tongue (GT) is a chronic condition of unknown aetiology, with no defined parameters to establish the protocol for evidence-based management. Validation of a newly developed and proposed clinical index to assess the severity of GT could assist in its diagnosis, especially in cases associated with systemic dermatological diseases in the form of psoriasis. Objective: To verify the applicability of the geographic tongue area and severity index (GTASI). This involved healthcare professionals from different specialties to evaluate the usefulness of the GTASI in supporting GT classification, as well as the follow-up process. Methods: One hundred cases of previously diagnosed GT were initially evaluated by three independent, experienced researchers/clinicians to obtain a standardised classification baseline. Subsequently, nine cases of GT were selected, three cases for each category—mild, moderate and severe. These stages were professionally evaluated by 51 healthcare professionals from three groups: 17 dentists (33%), 22 oral medicine specialists (43%) and 12 specialist dermatologists (24%) during a cross-sectional survey. Results: The quantitative and qualitative assessment based on experts’ opinions in the cross-sectional survey demonstrated an acceptable, similar level of GT clinical diagnosis (p > 0.05), with coherence between the various groups of professionals critically appraising the GTASI. An apparent divergence was observed for the moderate GT category, as well as in the group of less experienced evaluators. Conclusion: Whilst the validation of GTASI applicability was successfully executed, the general dental practitioners, specialists in oral medicine and dermatologists were equally capable of correct GT diagnosis and appropriately rating its severity. These coherent results were especially replicated among the experienced clinicians. The validation of the newly proposed index confirmed its reliability as a feasible instrument in oral medicine, with the prospect of its wider implementation in clinical practice.
Highlights
Geographic tongue (GT) is classified as a chronic and immunologically mediated condition characterised by a lymphocytic response that generates epithelial atrophy, of the filiform papillae
The group of evaluators that conducted the geographic tongue area and severity index (GTASI) validation in clinical settings consisted of 51 professionals: 17 dentists (33%), 22 oral medicine specialists (43%) and 12 dermatologists (24%)
Three GT cases from each GTASI category were sent to new evaluators and the most experienced specialists were considered as “gold standard” experts
Summary
Geographic tongue (GT) is classified as a chronic and immunologically mediated condition characterised by a lymphocytic response that generates epithelial atrophy, of the filiform papillae. It has been described for decades, its etiopathogenesis remains unknown [1,2]. This oral lesion has been associated with systemic diseases, primarily psoriasis, and is considered an oral manifestation and soft tissue “marker” of the severity of some dermatoses [3–5]. Erythematous atrophic areas, often circumscribed by a slightly elevated white halo, are usually observed, with episodes of spontaneous remission, exacerbation and migration of the lesions [6–8]. Tongue lesions are usually asymptomatic; in some cases, patients may report nonspecific symptoms in the form of burning, pain or tingling sensations of the lesions [5,9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
